News April 1, 2014

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C-Reactive Protein: Do You Need the New Blood Test?

When it comes to heart-related blood tests, C-reactive protein (CRP) is getting a lot of attention. Proponents maintain that we should measure CRP levels in all patients and use the results to guide therapies designed to help prevent coronary heart disease. There are equally vocal opponents of routine CRP testing.

CRP in the blood provides a general indication of inflammation in the body. In the presence of inflammation, CRP levels go up. Because coronary heart disease is an inflammatory process, it is associated with increased CRP. A person with a higher CRP level faces an increased risk of future cardiovascular events. As with any test, the question centers on what we do with test results. How can we use them to improve health?

We measure CRP levels in some, but not all, patients. Specifically, we use CRP levels to help us decide for or against a statin prescription in patients with cardiovascular risk factors but normal or only slightly elevated cholesterol. A large clinical trial demonstrated that patients with high CRP values and normal LDL levels benefited from statin therapy. On the other hand, if you have established coronary heart disease or clearly elevated LDL, you require a stain anyway, and CRP may be unnecessary. Donít request this test just because it has gained media attention. Instead, ask your doctor if this test will help you formulate your medical plan.